Ann Arbor, MI. -- Despite enduring more invasive tests and medical procedures, patients who were treated
aggressively for early stage bladder cancer had no better survival than patients who were treated less aggressively. Further,
the aggressively treated patients were more likely to undergo major surgery to have their bladder removed, according to a new
study from researchers at the University of Michigan Comprehensive Cancer Center.

Because bladder cancer is often treated as a chronic disease requiring lifelong surveillance, it is among the most expensive
cancers to treat in the United States. Urologists vary widely in how they approach early stage, or non-muscle-invasive, bladder
cancer.

In this study, researchers gathered data from the
Surveillance, Epidemiology and End Results Medicare database. They looked at
940 doctors who provided care to 20,713 early stage bladder cancer patients. Each doctor included in the study had treated at least
10 patients for bladder cancer.

The study found that average per-patient treatment expenditures ranged from $2,830 for doctors in the low-intensity treatment
category to $7,131 for doctors in the high-intensity category. At the same time, survival rates across all intensity categories
were similar.

"What this indicates is that some doctors are providing potentially unnecessary care, or care without measurable benefit to the
patient. It makes sense to many doctors and patients that more would be better, but unfortunately there can be unintended
consequences of unneeded care," says study author
Brent Hollenbeck, M.D., M.S., assistant professor of urology at the
U-M Medical School.

The study found that patients treated more aggressively had more imaging procedures and more invasive surgical procedures.
The aggressively treated patients were also nearly twice as likely to require major medical interventions, and were 2.5 times
more likely to undergo radical cystectomy, a procedure to remove the bladder.

The study authors suggest that certain patients might still benefit from greater intensity of care, but further research is
needed to determine which patients would benefit. Hollenbeck also urges randomized clinical trials to look at the value of
some of the more expensive and common health services to determine their optimal use for patients with early stage bladder cancer.

"Urologists should not assume that more aggressive management of early stage bladder cancer will translate into better outcomes
for their patients. By reducing unnecessary health care, we can reduce wasteful spending, which will lessen the cost burden of
bladder cancer, one of the most expensive cancers to treat from diagnosis to death," Hollenbeck says.

Bladder cancer statistics:
68,810 Americans will be diagnosed with bladder cancer this year and 14,100 will die from the disease, according to the
American Cancer Society.